Our results imply that variations in vitreal TAT level may be attributable not only to an inflammatory reaction or blood-retinal barrier breakdown, but also to intraocular tissue-dependent regulation of thrombin.
Rates of primary failure and disc dislocation for DSAEK decrease as surgeons gain experience with the procedure, and the number of functional grafts increases accordingly. Visual outcome improves regardless of surgical experience.
There do not appear to be any major differences in the biology or clinical manifestations of GC in Israel. Western recommendations for diagnosis and treatment of GC may therefore be applied to the Israeli patient population.
Retained Descemet's membrane (DM) following penetrating keratoplasty (PKP) is a rare finding that may reduce visual acuity following opacification or endanger the graft endothelium. The association between Nd:YAG laser membranotomy and corneal graft failure is reported. Five of 1,350 patients (0.37%) undergoing PKP for pseudophakic bullous keratopathy or graft failure between 1986 and 2008 presented with inadvertent retained DM located close to the graft endothelium. The membrane opacified within 3 to 4 months, reducing the patients' vision. Nd:YAG laser membranotomy was performed using low energy and few pulses. Patients' visual acuity improved from 6/40 to 6/90 before treatment to 6/15(-) to 6/20 at 2 weeks following membranotomy. However, the corneal graft decompensated within 6 to 8 weeks following this procedure, necessitating repeat PKP, with removal of the retained DM. Nd:YAG laser membranotomy may lead to corneal graft failure due to shockwave damage created by the laser pulses, focused near the endothelial surface.
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